Who is CAPA?
CAPA is the Canadian Association of Physician Assistants, a national professional organization that advocates for Physician Assistants (PAs) and represents its membership across Canada and globally. CAPA has established and maintains the national standard of practice for PAs, the Scope of Practice and National Competency Profile. It assists in providing the National Certification Process, the National PA Entry to Practice Certification Exam, and Registry for its members. CAPA's goal is to provide efficacious health professionals to the Canadian public, and to foster the development of the profession in all provinces. By helping to develop educational programs and assisting legislators, CAPA ensures quality health provision for Canadians.
Are Physician Assistants regulated through a college?
It is CAPA's vision to eventually have all PAs regulated within Canada and registered with the Provincial College of Physicians and Surgeons. Regulation is handled differently in each province/territory. In the provinces of Manitoba and New Brunswick, PAs are regulated through the Provincial College of Physicians and Surgeons. In Alberta, PAs are registered through the College of Physicians and Surgeons of Alberta. However, they are not regulated. In the province of Ontario, PAs work under Delegated Medical Acts and directions of their Physician.
Are Physician Assistants replacing any other providers?
No. PAs work to enhance the practice and the lifestyle of the entire medical team. They are integral to the team, and supplement, not supplant the work of physicians. PAs work within inter-professional teams that might include nurses, nurse practitioners, physiotherapists, physicians, and other providers. Every health professional serving patients brings unique qualities and experiences to the work they do, and does so in collaboration with the rest of the care team.
Can Physician Assistants safely deliver health care?
Yes. Canadian Forces PAs have been providing care safely in Canada and abroad for many years. The United States has over 40 years of successful integration of PAs in the health workforce. Studies of PAs practicing in other countries indicate that the in-hospital mortality rate of patients who were treated by PAs is no different from the rates associated with other health professionals. There is also no difference in incidence of drug reactions, medical errors, or complications, or need for additional medical interventions when care is delivered by PAs.
Does becoming a Physician Assistant makes it easier to become a doctor?
Physician Assistants want to be Physician Assistants. There is no short cut and no stepping stone from the Physician Assistant profession to that of a physician, in the same way that there are no shortcuts to becoming a PA.
How did the Physician Assistant profession begin?
In the mid-1960s, physicians and educators recognized there was a shortage and uneven distribution of primary care physicians. To expand the delivery of quality medical care, Dr. Eugene Stead of the Duke University Medical Center in North Carolina put together the first class of PAs in 1965. He selected Navy corpsmen who received considerable medical training during their military service but who had no comparable civilian employment. He based the curriculum of the PA program, in part, on his knowledge of the fast-track training of doctors during World War II.
In Canada, Physician Assistants evolved from Sick Berth Attendants of the Navy, and Medical Technicians with advanced responsibility in the military. They had extensive training and with formal education expanded their role to meet the needs of the services in all the different environments the Canadian Forces Served.
For more information about the history of the PA profession, visit the American Academy of Physician Assistant's PA History Center web page. www.pahx.org
How do I become a Physician Assistant?
At present there are four Physician Assistant Education Programs (PAEP) in Canada: the Canadian Forces Medical Services School, the University of Manitoba, McMaster University, and the PA Consortium (University of Toronto, Northern Ontario School of Medicine and the Michener Institute of Applied Sciences). PAEP includes one year of didactic classroom medical education and 12-14 months of clinical exposure and rotations at hospitals and medical clinics throughout Canada. All programs meet the same standard and apply for accreditation from the Canadian Medical Association's Conjoint Accreditation Services.
Willis Insurance currently offers liability insurance for Certified Physician Assistants (Canadian or US) who are members of CAPA. In some jurisdictions PAs are covered under the employer's comprehensive general liability insurance. The Canadian Medical Protective Association provides professional liability protection to those physicians who supervise and work with PAs.
The designation Canadian Certified Physician Assistant or CCPA means that the person who holds the title has met the defined course of study and has undergone testing by the Physician Assistant Certification Council of Canada (PACCC). The PACCC is an independent Council of the Canadian Association of Physician Assistants (CAPA) that administers and maintains the PA certification process. The Certification Council consists of various members of the medical community that represent a number of different viewpoints and concerns as well as those of Physician Assistants.
Accredited PA education programs are available in Canada and in the US. There are currently four PA education programs in Canada: three of which are accredited and the fourth has applied for accreditation. The three accredited programs are: the Canadian Forces Medical Services School, the University of Manitoba, and McMaster University. The PA Consortium (University of Toronto, Northern Ontario School of Medicine and the Michener Institute of Applied Sciences) is the fourth program. Training in accredited programs focuses on understanding the pathophysiology of disease, differential diagnosis determination, and treatment plan development. The programs includes one year of clinical rotation in areas such as emergency medicine, pediatrics, internal medicine, orthopedics, sports medicine, general surgery, urology, anesthesia, trauma team and family practice.
As of September 2008, Canada has three civilian Physician Assistant Education Programs. The University of Manitoba, in Winnipeg, is offering a Master of Physician Assistant Studies (MPAS), while McMaster University in Hamilton, and the PA Consortium (University of Toronto, Northern Ontario School of Medicine, and the Michener Institute of Applied Sciences) in Toronto, hosts a Bachelor of Health Sciences (Physician Assistant) program. All accredited PAEP will allow graduates to challenge the Canadian PA Entry to Practice Certification Examination.
The relationship between a PA and the supervising physician is one of mutual trust and respect. The physician assistant is a representative of the physician, treating the patient in the style and manner developed and directed by the supervising physician. The physician and PA practice as members of a medical team.
The PA role is designed to provide Canadians with improved access to appropriate health care providers, with the goal of improved patient satisfaction and patient care. Importantly, the literature demonstrates that PAs are effective providers when measured against patient safety, quality of care, and productivity. Physician Assistants make a significant contribution to the health care system wherever they are found.
Physician assistants are educated in the medical model; in some schools they attend many of the same classes as medical students. One of the main differences between PA education and physician education is not the core content of the curriculum, but the amount of time spent in formal education. In addition to time in school, physicians are required to do an internship, and complete a residency in a specialty following that. PAs do not have to undertake an internship or residency.
In the Canadian Forces, Physician Assistants support supervising physicians with medical emergencies as well as everyday health care needs. In civilian practice, PAs work in primary care and specialty practice, in hospital and community care settings, and in physician employed settings. care centers, and many other areas of Health Care. 79,000 PAs assist physicians in a variety of settings, including urban neighborhoods, rural communities, hospitals, doctor's offices, the military and public health. About 50% work in primary care, with the balance in specialties including surgery, internal medicine and emergency care.
Physician Assistants (PA) are highly skilled health professionals who support physicians in all health care settings. In Canada, the PA role was developed within the Canadian Forces Health Services to provide a full spectrum of medical care. Within a formal Physician/Physician Assistant relationship, a PA has the skills and experience to deal with medical emergencies, specialty practice environments, as well as everyday health care needs. Depending on the agreement between the physician and the PA, activities may include conducting patient interviews, histories, physical examinations; performing selected diagnostic and therapeutic interventions; and counseling on preventive health care. The PA is a physician extender and not an independent practitioner; they work under the direction of supervising physicians within the client/patient-centered care team.
As part of their comprehensive responsibilities, PAs conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and write prescriptions. Within the physician-PA relationship, physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services. A PA's practice may also include education, research, and administrative services.
How do I register for the Certification Exam?
The registration form will be made available on line, simply down load the form, complete and Fax to CAPA head Office. Once the registration form and fees have been received, a receipt will be mailed, this receipt must be produced at the time of writing.
What if I am not successful?
At the present time you are still eligible to sit for the next certification exam. These exams will be offered only once a year. A policy on the number of attempts to write the exam is being developed and will be communicated as soon as the policy is completed.
All candidates must meet all of the following requirements:
• Properly complete the PA Entry to Practice Certification Examination registration form by the established deadline;
• Be a member of the Canadian Association of Physician Assistants (CAPA).
To establish eligibility to challenge the PA Entry to Practice Certification Examination all applicants must also meet one or more of the following:
• Graduate of the Canadian Forces Medical Services School (CFMSS) PA Program prior to 2004 (This eligibility will remain valid until and including the 2014 exam. Requires validation of successful completion from the CFMSS PA Program. Proof of clinical practice within 5 years of the examination date supported by the supervising physician indicating the applicant has been in clinical practice.)
• Graduate of a Canadian Medical Association (CMA) accredited PA program (Requires validation of successful completion of a CMA accredited PA program.) and/or
• Graduate of an Accreditation Review Commission (ARC) program and certified by the National Commission of Certification for Physician Assistant (NCCPA) (Requires validation of successful completion of an ARC accredited US PA program and proof of current NCCPA membership. NCCPA member number must be included on the registration form.)
The exact dates, timings and actual location will be made available on the web site.
Continuing Professional Development
Mainpro 1 credits will normally be received from formal learning activities such as conferences, on-line registered CPD for which certification is received, and pre-established courses for which a fixed amount of credit has been pre-determined. Formal journal clubs who set learning objectives, keep a record of the journal topics covered, perform an evaluation of their learning and meet a minimum of eight times per year may also be credited as Mainpro 1 credit hours. However each of such clubs must make a specific submission to the CPD Committee and request acceptance in advance.
Mainpro 2 credits are earned through a self-directed learning process. To be effective, each PA should set individual goals and design the appropriate strategy to ensure their objectives are met. Learning activities that may be counted for Mainpro 2 credit hours may include, but are not limited to: journal reading; review of internet articles; participation in an informal journal club; non-accredited medical rounds; participation in an online community of practice; and mentoring. PAs who provide informal unit-level CPD to other health professionals may record these teaching hours for Mainpro 2 credits. Similarly, Mainpro 2 credit hours may be counted for activities such as participation for example on a Test Committee on a one for one hourly basis.
A maximum of 25 hours of Category I credits may be carried over to the next five year cycle.
How am I going to keep track of my CPD?
There will be a form on line that everyone can use to track CPD hours. Once a year the form will be completed and sent via e-mail or fax to the CAPA National Office, attention Certification Council. This has to be received no later than the 15th December each year.
PACCC will be using an audit process in that members will be selected randomly and they will be asked to submit documentation supporting Mainpro 1 hours.
Please review the documentation on the web site, as it spells out the requirement for CPD.
The CPD cycle will last 5 years, beginning 01 January of the year in which you have received your successful completion letter.